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Drive to detecting lung cancer early in Scotland and England

In a bid to enable early diagnoses of lung cancer NHS England recently announced plans to fund and
roll out portable CT scanners throughout the country in an effort to provide early intervention and
treatment. It is widely recognised that treatment and survival rates can be improved if cancer is
detected at a more treatable stage.

This decision followed a successful pilot scheme initially in Manchester in November 2016 which saw
the use of mobile lung testing stations in supermarket carparks across three main areas of the city.
Manchester has one of the country’s premature cancer death rates in people under the age of 75
years.

Directed at smokers and ex-smokers between the age of 55 and 74 years over 2,500 invited
participants responded by attending pre-arranged appointments with a lung specialist nurse where
they undertook a lung function test (spirometry) which is used to calculate their lung cancer risk.
Anyone considered high risk was invited to have an immediate low-dose CT scan whilst those
displaying other symptoms of concern were invited to discuss matters with their GP to ensure
appropriate treatment and support was offered.

CT scan results were reported on by a Specialist NHS Consultant within 14 days and in appropriate
cases a follow-up scan was obtained 3 months later. In instances where a suspicion of lung cancer
existed immediate review was made by the lung cancer team and follow up investigations made and
treatment offered wherever required.

The results of the Manchester health checks indicated a far better response than had been
anticipated with over 2,500 attending appointments reflecting an even spread of men and women.
In just over half the cases a CT scan was deemed appropriate from which 42 patients were
diagnosed with lung cancer. Most cancers found were of an early stage with 1 in 10 representing an
advanced cancer (stage 4) enabling potentially curative treatment to be offered to 9 out of 10 with
lung cancer. The scheme was expanded into other regions including the North West and Cumbria,
Yorkshire, Lincolnshire and London. NHS England recognises the value of early detection in cancer
which potentially could save thousands of lives.

In 2013 across parts of Scotland 12,000 high risk cancer volunteers made up of smokers and ex-
smokers became the first to trial a new blood test known as EarlyCDT-Lung test which is designed to
detect substances in the blood, known as autoantibodies, which the body produces when cancer
cells has formed. Identification of these antibodies can help to identify a cancer potentially up to
five years before the cancer could be detected by traditional scans.

Those proving a positive blood test went on to have a chest x-ray and CT Scan to investigate if cancer
was present. Whilst heavy smokers are particularly at risk it remains impractical to scan everyone at
risk which serves only to create unnecessary worry and expense. Ct scans alone can falsely suggest
lung cancer by detecting incidental and clinically irrelevant findings.

The research study is a collaboration between Greater Glasgow, Clyde, Lanarkshire and Tayside
Health Boards, the universities of Aberdeen, Dundee, Glasgow, Nottingham, Toronto and the
Scottish Cancer Registry. Completion date is estimated to be August 2018, albeit early results
reported in December 2016 have been reported as ‘encouraging’.

Lung cancer is one of the most common forms of cancer within the UK and accounts for more than
45,000 diagnoses each year with as many as 4 in 5 cases caused through smoking. Scotland has one
of the highest incidence rates in the world, particularly in Greater Glasgow and Clyde.
Other causes of lung cancer include exposure to certain chemicals, radiation and asbestos fibres.

Asbestos related lung cancer can take between 10 and 50 years to develop after exposure to
asbestos fibres with common symptoms including chest, back and shoulder pain, stubborn cough,
persistent chest infections, loss of appetite, unexplained weight loss, coughing up blood and
persistent tiredness or lack of energy.

There is a recognised relationship between smoking and asbestos exposure which confirms that
smokers who are exposed to asbestos fibres have an increased risk of developing lung cancer.
Interestingly, government smoking statistics obtained through General Household Survey’s (GHS)
showed a peak in the number of male smokers in the 1960’s and in 1974 showed 45% of the
population 16 years and over were cigarette smokers. Heavy industry and shipbuilding along the
River Clyde is also likely to be a factor reflecting the wide scale use of asbestos between the 1930’s
and 1960’s.

Asbestos was widely used across many industries from the 1940’s into the 1980’s before it was
eventually banned by legislation in 1999. Asbestos related lung cancer is generally associated to
those trades involving moderate to heavy exposure which is likely to include,

  • Laggers
  • Ship builders
  • Plumbers
  • Heating engineers
  • Electricians
  • Carpenters
  • Mechanics
  • Boiler makers
  • Metal workers
  • Roofers
  • Factory workers

Asbestos related lung cancer can sometimes be difficult to determine and almost certainly hinges
upon the nature and extent of exposure to asbestos fibres which require the assessment of an
experienced industrial disease solicitor. In many instances lung cancer is accompanied by other
asbestos-related conditions such as pleural plaques, pleural thickening and asbestosis but this is not
always the case and therefore all exposure needs to be discussed and considered carefully in line
with long standing international criteria used by the legal and medical profession.

Anyone diagnosed or affected by an asbestos-related disease which might include, pleural plaques,
pleural thickening, pleural effusion, asbestosis, lung cancer or mesothelioma are invited to contact
us on FREEPHONE 0808 164 7740 or email us at, info@scottishasbestoshelpline.co.uk.
Our Solicitors are leading Industrial Disease experts with a wealth of experience and expertise in all
aspects of asbestos health who work on a completely ‘no win no fee’ basis to provide peace of mind
against any legal costs should your case be unsuccessful for any reason.
Visit us at, www.scottishasbestoshelpline.co.uk.